METHODS: PubMed, EMBASE, and Cochrane databases were searched from inception to April 12, 2022; ClinicalTrials.gov was searched in September 2022 (PROSPERO 2022 CRD42022326255). Randomized and nonrandomized studies of urogynecologic POP surgery outcomes were accepted in which categories of BMI or obesity were compared.
METHODS: In total, 9,037 abstracts were screened; 759 abstracts were identified for full-text screening, and 31 articles were accepted for inclusion and data were extracted.
RESULTS: Studies were extracted for participant information, intervention, comparator, and outcomes, including subjective outcomes, objective outcomes, and complications. Outcomes were compared among obesity categories (eg, BMI 30-34.9, 35-40, higher than 40), and meta-analysis was performed among different surgical approaches. Individual studies reported varying results as to whether obesity affects surgical outcomes. By meta-analysis, obesity (BMI 30 or higher) is associated with an increased odds of objective prolapse recurrence after vaginal prolapse repair (odds ratio [OR] 1.38, 95% CI, 1.14-1.67) and after prolapse repair from any surgical approach (OR 1.31, 95% CI, 1.12-1.53) and with complications such as mesh exposure after both vaginal and laparoscopic POP repair (OR 2.10, 95% CI, 1.01-4.39).
CONCLUSIONS: Obesity is associated with increased likelihood of prolapse recurrence and mesh complications after POP repair.
BACKGROUND: PROSPERO CRD42022326255.
方法:PubMed,EMBASE,和Cochrane数据库从开始到2022年4月12日进行了搜索;ClinicalTrials.gov于2022年9月进行了搜索(PROSPERO2022CRD4202236255)。接受泌尿系妇科POP手术结局的随机和非随机研究,其中比较了BMI或肥胖的类别。
方法:总共,筛选了9,037篇摘要;确定了759篇摘要用于全文筛选,31篇文章被接受纳入并提取数据。
结果:提取了参与者信息的研究,干预,比较器,和结果,包括主观结果,客观结果,和并发症。结果在肥胖类别之间进行了比较(例如,BMI30-34.9,35-40,高于40),并对不同手术入路进行荟萃分析.个别研究报告了肥胖是否影响手术结果的不同结果。通过荟萃分析,肥胖(BMI30或更高)与阴道脱垂修补术后(比值比[OR]1.38,95%CI,1.14~1.67)和任何手术方法脱垂修补术后(OR1.31,95%CI,1.12~1.53)的客观脱垂复发几率增加相关,并且与阴道和腹腔镜POP修补术后网状物暴露等并发症相关(OR2.10,95%CI,1.01~4.39).
结论:肥胖与POP修复后脱垂复发和网状并发症的可能性增加有关。
背景:PROSPEROCRD42022326255。